Organization
BOSTON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELAINE RUSSO BOUCHER RN. NP. (NURSE PRACTITIONER)
(617) 414-8258
Entity
Organization
Contact information
Practice address
732 HARRISON AVE, SUITE 500, BOSTON, MA 02118-2309
(617) 638-8400
(617) 638-8406
Mailing address
18 WAREHAM ST, MEDFORD, MA 02155-6222
(617) 638-8400
(617) 638-8406
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
MA106293
MA
Other
Enumeration date
04/17/2007
Last updated
08/07/2008
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